When There Is Value in Asking: An Argument for Social Risk Screening in Clinical Practice
Authors: Elena Byhoff, Laura M. Gottlieb
Journal: Annals of Internal Medicine (2022)

Ideas and OpinionsAugust 2022When There Is Value in Asking: An Argument for Social Risk Screening in Clinical PracticeElena Byhoff, MD, MSc and Laura M. Gottlieb, MD, MPHElena Byhoff, MD, MScDepartment of Medicine, Tufts Medical Center, Boston, Massachusetts (E.B.) and Laura M. Gottlieb, MD, MPHDepartment of Family and Community Medicine, University of California San Francisco, San Francisco, California (L.M.G.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0147 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Assessing patients' social context is increasingly considered an essential step on the road toward health equity. Yet, health care clinicians have not wholly embraced social-screening practices (1). Clinicians cite several reasons for their reluctance to collect social needs information, chief among which is the inability to "cure" social adversity (2). Garg and colleagues argue that screening for social risks without a solution for the many consequences of poverty and structural racism can result in unintended harms for patient trust and clinician empowerment (3). This framing undermines the benefits of social screening, which are distinct from the screen and referral pathway.... References1. Cartier Y, Gottlieb L. The prevalence of social care in US health care settings depends on how and whom you ask. BMC Health Serv Res. 2020;20:481. [PMID: 32471466] doi:10.1186/s12913-020-05338-8 CrossrefMedlineGoogle Scholar2. Quiñones-Rivera A, Wing HE, Barr-Walker J, et al. Provider impacts of socioeconomic risk screening and referral programs: a scoping review. J Am Board Fam Med. 2021;34:820-831. [PMID: 34312275] doi:10.3122/jabfm.2021.04.210039 CrossrefMedlineGoogle Scholar3. Garg A, Boynton-Jarrett R, Dworkin PH. Avoiding the unintended consequences of screening for social determinants of health. JAMA. 2016;316:813-4. 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[PMID: 16405707] doi:10.1111/j.1525-1497.2006.00302.x CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Department of Medicine, Tufts Medical Center, Boston, Massachusetts (E.B.)Department of Family and Community Medicine, University of California San Francisco, San Francisco, California (L.M.G.).Grant Support: By National Institute on Minority Health and Health Disparities grant K23MD015267 (Dr. Byhoff).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0147.Corresponding Author: Elena Byhoff, MD, MSc, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box #63, Boston, MA 02446; e-mail, [email protected]org.Author Contributions: Conception and design: E. Byhoff, L.M. Gottlieb.Analysis and interpretation of the data: E. Byhoff, L.M. Gottlieb.Drafting of the article: E. Byhoff, L.M. Gottlieb.Critical revision of the article for important intellectual content: E. Byhoff, L.M. Gottlieb.Final approval of the article: E. Byhoff, L.M. Gottlieb.This article was published at Annals.org on 14 June 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics August 2022Volume 175, Issue 8Page: 1181-1182KeywordsHealth care qualityHealth screeningPrecision medicine ePublished: 14 June 2022 Issue Published: August 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...